Do Hospitals Get Prestigious National Awards for Poor Nursing?

In this Revolution and Revelation, Milton Packer, MD, discovers that you can't judge hospital quality by nursing awards

A member of my family was recently admitted to the hospital to have a procedure to repair a heart problem.

The hospital was brand new, and it had been honored as a Magnet by the American Nurses Credentialing Center. Wow, I thought: The nursing must be outstanding.

During the 5-day hospital stay, I witnessed some of the most unusual nursing practices that I had seen in my 40-year career.

Everyone knows that the traditional role of nurses has changed over the past decade. In-hospital care is now reliant on "patient care assistants" and "floor coordinators," who respond to personal needs and take vital signs and ensure that patients know how to ask for help.

So what do nurses do? Here is what I found out.

Nurses place cardiac monitors on patients. But when the alarms on the monitors go off, the alarms are ignored for hours. My family member had a (falsely) recorded blood pressure of 60 mmHg systolic for 2 hours before someone responded to repeated calls to stop the alarm.

The patient bed was programmed to ensure that bed rest was maintained. When my family member wanted to use the bathroom and did not get any help, she got out of bed. A screeching alarm went off. It was ignored for 45 minutes.

My family member needed an IV line, and fortunately, has terrific veins. But none of the nurses knew how to put one in even though they had been certified to do so. I watched their bungling efforts in horror. After multiple failed attempts, the nurse asked if my family member still wanted an IV, hoping for a refusal. I was tempted to place the IV myself, because it would have been so easy, even though I had not put an IV into anyone in about 20 years.

The night shift was truly remarkable.

Nurses came in on two occasions to administer medications that had been prescribed to other patients. There was a policy to obtain a urine pregnancy test prior to an x-ray procedure, so they insisted on having one done, even though my family member had been postmenopausal for years. They said that the policy applied to everyone. I wondered if they applied it to men.

After a femoral procedure resulted in oozing, the physician asked the nurse to replace the bandage and apply pressure for 15 minutes. The nurse replaced the bandage. No pressure was ever applied.

Every interaction with the staff was mechanical. Every movement had been dictated in advance. Every word used in communications had been preapproved. Forms needed to be checked, whether or not they had relevance. But the really important questions were never asked.

It is easy to understand why the hospital had won a prestigious nursing award. They did everything by the book, whether or not it made any sense. Whether or not, they did it well. Whether or not, it was in the patient's interest. But it was all perfectly documented.

For 5 days, many robots came in to deliver care. They did an outstanding job fulfilling the role of robots. But for some reason, they called themselves "hospital staff". All of them were very nice, but they had this empty look in their eyes. I remember that look from old zombie movies.

I learned something from all of this. Many experts are predicting that humanity needs to fear the rise of artificial intelligence. But my experience suggests otherwise.

I think that artificial intelligence really needs to worry about competition from human beings.

Humans can act like robots much better than robots can act as robots.

Packer has recently consulted for Amgen, Boehringer Ingelhim, Cardiorentis and Sanofi. He was one of the two co-principal investigators for the PARADIGM-HF trial (sacubitril/valsartan) and currently chairs the Executive Committee for the EMPEROR trial program (empagliflozin).

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